Dispositivos de avanço mandibular no tratamento da Síndrome da Apneia Obstrutiva do Sono

: revisão sistemática

Abstract

Introduction: Obstructive Sleep Apnea Syndrome is a sleep-related respiratory
disorder, classified by the Apnea/Hypopnea Index. One of the treatments
recommended for the mild and moderate forms of this pathology are the
Mandibular Advancement Devices. Thus, the aim of this systematic review is to
qualitatively assess the efficacy and the adverse effects of Mandibular
Advancement Devices in the treatment of Obstructive Sleep Apnea Syndrome
over time. Materials and Methods: This systematic review was written using the PRISMA guidelines. A search was carried out in the PubMed / MEDLINE®, Cochrane® and Web of Science - MEDLINE® databases, until April 15th, 2021. Two researchers selected the studies independently. The quality of the papers was assessed using the Downs and Black checklist and the agreement between
examiners was measured using the Cohen's kappa coefficient. Results: Through the research, 2011 articles were identified. After removing duplicates and triplicates, the title of 662 articles was analyzed. Among these, 339 were examined by abstract and 62 by full reading. After this selection, 16 articles were eligible for analysis. Conclusion: Mandibular Advancement Devices increase the area of the airways through displacement of the mandible anteriorly and inferiorly, displacement of the soft palate, tongue and hyoid bone anteriorly and activation of the masseter and submentonian muscles. These effects cause a decrease in Apnea/Hypopnea Index, an increase in oxygen saturation and an improvement in the symptoms of Obstructive Sleep Apnea Syndrome, thus being effective in its treatment. However, due to their intraoral placement, they will cause side effects, despite not being considered a contraindication to treatment, should not be neglected. Possible side effects include reduced overjet and overbite, posteroinferior position of the mandible and joint discomfort.

Date of Award	23 Jul 2021
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Patrícia Fonseca (Supervisor) & Vanessa Silva (Co-Supervisor)